| Regimental number | 5567 |
| Place of birth | West Maitland New South Wales |
| Religion | Roman Catholic |
| Occupation | Carpenter |
| Address | West Maitland, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs I Welbourne, Rose Street, West Maitland, New South Wales |
| Enlistment date | 13 June 1916 |
| Rank on enlistment | Sapper |
| Unit name | Tunnelling Companies, October 1916, Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 25 October 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1st Tunnelling Company |
| Fate | Returned to Australia 20 June 1919 |
